This competing renewal application for the Delaware Valley (DV) Node requests 5 years of funding to continue its work. The DV Node, the Penn Center for Studies of Addiction of which it is a part, and the Treatment Research Institute where the Node is based, bring a wide range of expertise in selecting, conducting, and managing multi-site trials in community treatment programs. These qualities are reflected by our participation in 5 trials during the last period of funding including a study of extended buprenorphine- naloxone treatment for opioid addicted youth (#0010) that was developed and led by our Node, published in JAMA along with a commentary, and received national and international attention; a cost-effectiveness study that was developed by collaboration between Dr. Dan Polsky, a health services researcher at Penn and the DV Node, funded as an R01, and documented the costs and benefits of the two treatments in study #0010; a study of a computerized system to obtain patient feedback for therapists and program administrators that was developed and led by DV and resulted in additional NIDA grants to further explore its potential; a pharmacogenetic study of response to methadone and buprenorphine treatment that was led by a DV investigator; studies of HIV risk reduction in males and females; a study of OROS-MPH for substance abusing adolescents with ADHD; participating in CTN committees; helping develop protocols for new CTN studies; collaborating on papers from studies led by investigators at other Nodes; helping guide the career development of other investigators; giving keynote addresses at CTN Steering Committee and Blending meetings; having a Co-I selected as Deputy Drug Czar for Demand Reduction; and training fellows to conduct studies at international sites where data can be obtained that applies to the US but would be inordinately expensive or very difficult to do here and that extends the impact of the CTN beyond US borders. This work is done in collaboration with a wide range of investigators and sites that bring many different skills and patient populations to the CTN, and in the context of an infrastructure that can disseminate CTN findings to investigators, administrators and clinicians working in community based programs. PUBLIC HEALTH RELEVANCE: This application will support an infrastructure to conduct clinical trials for persons with substance use disorders at community treatment programs in Philadelphia and other parts of the country. Its overall purpose is to conduct rigorous trials of promising treatment strategies in real world situations and disseminate the results with the overall goal of improving the quality of addiction treatment both nationally and internationally.